IAMOT |
International Association for Management of Technology |
Membership Application IAMOT Membership Application [WORD DOC] |
IMPORTANT INFORMATION: The submit function has been disabled at this moment. Please send the form by fax at 305 284-4040 or by e-mail at iamot@miami.edu . Thank you.MEMBERSHIP CLASS INFORMATION:
FULL MEMBER: 1. Must possess appropriate academic qualifications in the form of relevant degrees at the B.S. M.S., sickness or Ph.D. level, sickness and be approved by the Executive Council (EC). 2. Must have at least five years of industry, order academic, or research experience in MOT as evidenced by significant contributions to engineering, management, research, publication, research reports, and other research activity. 3. Shall have all the privileges of membership, including participating in IAMOT General Meetings and receiving official IAMOT journal(s). 4. Shall be a voting member and eligible for holding any office in IAMOT.
STUDENT MEMBER: 1. Shall have provided documentary evidence of being enrolled as a graduate student in a relevant field. 2. Shall have an active interest in MOT and the application of MOT research outcomes in Industry. 3. Shall have all the privileges of membership, including participation in the IAMOT General Meeting. 4. Shall not be a voting member and be ineligible to hold any office in IAMOT. AFFILIATE MEMBERS: 1. Shall be a member of an IAMOT chapter or a member of a MOT related organization. 2. Membership in this category is subject to agreement between IAMOT and the MOT related organization, whereby an affiliate member would have the same privileges as a full IAMOT member, with the exception of voting right and receiving IAMOT official journal(s).
HONORARY MEMBER: 1. Shall be a recipient of a Certificate of Recognition as defined in VI.2, and not a member of IAMOT (in the event that the recipient is already a member, he or she shall retain his or her current membership status). 2. Shall have all the privileges and rights of a (Full) Member. 3. Shall not be required to pay any annual membership dues, but is encouraged to do so on a voluntary basis. |
IAMOT Membership Application |
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PERSONAL DATA |
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Name: ____Mr. ____Mrs. ____Ms. ____Dr. | |||||||||||||||||
First Name | Middle Initial: | Last Name: | |||||||||||||||
Current Home Address: | |||||||||||||||||
City: | State: | ZIP Code: | |||||||||||||||
Home Phone: | Cell Phone: | Other Contact Number: | |||||||||||||||
E-mail address: Website: | |||||||||||||||||
Current Employment or school Information |
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Company or School Name: | |||||||||||||||||
Address: | Department: | ||||||||||||||||
Phone: | E-mail: | Fax: | |||||||||||||||
City: | State: | ZIP Code: | |||||||||||||||
Where should mail be sent? | ____ to the home address | ____to the work/school address | |||||||||||||||
Website: |
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Professional Experience |
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Please begin with your most recent experience: | |||||||||||||||||
Company: | Department: | ||||||||||||||||
Location: | From: (Mo./Yr.) | To: (Mo./Yr.) | |||||||||||||||
Job Title: | |||||||||||||||||
Website: |
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Job Description (Optional): |
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Professional Experience |
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Company: | Department: | ||||||||||||||||
Location: | From: (Mo./Yr.) | To: (Mo./Yr.) | |||||||||||||||
Job Title: | |||||||||||||||||
Website: |
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Job Description (Optional): |
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ACADEMIC BACKGROUND |
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Please begin with your highest degree: | |||||||||||||||||
University or College: | Location: | ||||||||||||||||
Degree: | Major: | Minor: | |||||||||||||||
Years of Study: | From: (Mo./Yr.) | To: (Mo./Yr.) | |||||||||||||||
ACADEMIC BACKGROUND |
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University or College: | Location: | ||||||||||||||||
Degree: | Major: | Minor: | |||||||||||||||
Years of Study: | From: (Mo./Yr.) | To: (Mo./Yr.) | |||||||||||||||
academic background |
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University or College: | Location: | ||||||||||||||||
Degree: | Major: | Minor: | |||||||||||||||
Years of Study: | From: (Mo./Yr.) | To: (Mo./Yr.) | |||||||||||||||
endorsement for Students |
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Endorsement by a Faculty Member or School Official:
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Endorser’s Name and Title: | |||||||||||||||||
Mailing Address: | |||||||||||||||||
Fees |
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_______Full Member: $150. Annual Dues | _______Student Member: $50 | ||||||||||||||||
_______Affiliate Member: (through arrangement between IAMOT and the affiliate organization) | ______Honorary Member: Voluntary Contribution | ||||||||||||||||
Please note that you will be invoiced upon acceptance of membership. | |||||||||||||||||
Agreement and Signature |
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I hereby submit this application and any necessary support documentation for evaluation by the IAMOT . I understand that I may not be accepted in the membership class I have requested, but that I can resubmit my application for reclassification if I desire. | |||||||||||||||||
____Agree | ____Not Agree | ||||||||||||||||
Name: Signature:E-mail: | Date: | ||||||||||||||||
Revised: March 30, 2012